Left ventricular unloading via transseptal percutaneous cannulation in patients with Veno arterial extracorporeal membrane oxygenation: report of two cases.
Leonardo A Seoane, Rocío Baro Vila, Lucrecia Burgos et al.
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Case in brief
Two adult patients with cardiogenic shock on peripheral VA-ECMO developed severe left ventricular (LV) distension unresponsive to medical therapy and intra-aortic balloon pump support. Both underwent successful percutaneous transseptal LV cannulation, allowing effective LV decompression. One patient was bridged to heart transplantation, while the other experienced multiple ECMO-related complications and died after prolonged support.
Diagnostic / clinical pearl
Percutaneous transseptal LV cannulation can be a safe and effective method for LV unloading in patients on peripheral VA-ECMO, especially when other unloading devices are not available.
Why it matters
This case highlights an alternative approach to managing LV distension in critically ill patients, emphasizing the need for further research to optimize patient selection and procedural safety.